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Functional Medicine Lab Tests to Check Annually

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Functional medicine lab tests help a client and their practitioner identify and address imbalances within the body. They range from assessing hormonal balance, gut health, nutrient levels, mineral status, adrenal function, and so much more.

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One of the most common questions I’m asked as a Functional Medicine Practitioner is what type of lab tests should be checked on a regular basis. I always love this question because I am a huge proponent of lab testing. Functional medicine lab tests, in particular, are especially helpful in addressing imbalances and dysfunctions in the body and are a critical tool in functional medicine. 


Functional medicine lab tests help a client and their practitioner identify and address imbalances within the body. This is a huge aspect, if not the biggest aspect, of functional medicine. Unlike conventional medicine, functional medicine takes a bio-individual, root cause approach to healthcare that considers a wide range of factors, such as diet, lifestyle, genetics, hormones, gut infections or imbalances, food sensitivities, environmental toxins, and more. While conventional medicine simply masks or “band-aids” symptoms with medication and pills, functional medicine looks at the big picture. Functional medicine lab tests are a primary tool in addressing the root cause of symptoms. 

Functional medicine lab tests range from assessing hormonal balance, gut health, nutrient levels, mineral status, adrenal function, and so much more. The key is not just in the labs itself, but in the interpretation and more so, in the application. 


Have you ever visited the doctor, feeling like something is “off” while struggling with mystery symptoms? Yet, after running lab work, the doctor confirms that everything looks “normal” and you’re back to square one? This is a common and frustrating scenario within the Western medical community for many reasons. To start, conventional labs do not always address or check the correct markers. In addition, conventional lab ranges are often too broad, leading to false interpretation.

In conventional medicine, “normal” lab ranges are not always considered to be optimal. This explains why those with chronic, mystery symptoms are often told they have “normal” lab ranges. Instead, optimal lab ranges are significantly more narrow, allowing for imbalances and dysfunctions to be detected. More so, we need to be in optimal ranges for our body to perform at it’s best!

conventional versus functional medicine lab test ranges

Conventional lab ranges are often broad reference ranges that analyze samples based on a healthy population. Lab results can fall within the “normal” range during the early stage of disease, which allows dysfunctions to be overlooked.


Functional medicine lab ranges are narrow reference ranges to analyze samples, focusing on optimal levels rather than broad population norms. They aim to detect imbalances and dysfunctions early, offering a much more proactive approach to healthcare.

Example lab ranges:

Let’s take a look at common differences between conventional and functional medicine lab ranges:


  • Conventional: 20-40 ng/mL
  • Functional Medicine: 60-70 ng/mL

TSH (Thyroid):

  • Conventional: 0.45-4.12 mlU/L
  • Functional Medicine Optima: TSH of 0.5-2.5 mlU/L
conventional versus functional medicine lab test ranges

From these common examples, you can see how frequent imbalances or dysfunctions within the body are misdiagnosed or negated all together. This is why I am so passionate about functional medicine lab tests and use them often as an integral part of my practice!


You might be wondering, who is a candidate for functional medicine lab tests? While I think everyone should utilize functional medicine lab tests on an annual basis, I would encourage you to ask yourself the questions below. If you answer “yes” to 1 or more of them, take the next step of getting tested. 

when you should ask for functional medicine lab tests
  1. Am I experiencing persistent fatigue, feeling tired even after adequate rest and sleep?
  2. Do I deal with gastrointestinal distress, such as stomach pain, bloating, gas, diarrhea, or constipation?
  3. Are skin issues like acne, eczema, rosacea, or unexplained rashes a concern for me?
  4. Have I been diagnosed with autoimmune conditions (IBS, leaky gut, SIBO, etc), and/or do I experience symptoms related to them, such as joint pain, fatigue, or inflammation?
  5. Is my cholesterol level consistently high?
  6. Do I suffer from chronic heartburn or acid reflux, leading to discomfort after eating?
  7. Am I prone to frequent headaches, including migraines or tension headaches?
  8. Do I experience persistent joint pain, stiffness, or swelling in specific areas of my body?
  9. Have I noticed sensitivities or allergic reactions to certain foods, leading to digestive discomfort or skin issues?
  10. Am I susceptible to recurrent chronic infections, like urinary tract infections (like UTIs)?
  11. Do I struggle with chronic allergies or sinus issues, experiencing symptoms like congestion, sneezing, or postnasal drip?
  12. Have I been experiencing unexplained weight changes, whether gaining or losing weight unintentionally?
  13. Have I noticed mood swings, changes in mental clarity, or cognitive issues like brain fog?
  14. Have I noticed changes in my sleep patterns, such as difficulty falling asleep, staying asleep, or experiencing restless nights?

Many of the above may be common in our world today, but friend, I am here to tell you that they are not normal. You can live without pain or constant symptoms. By inviting functional medicine lab tests can help identify the root cause of these common symptoms and eliminate them for the long run. Freedom IS available to you! 


Even when you’re not experiencing active symptoms, getting regular functional medicine lab tests is a preventive measure that allows you to proactively monitor your health. These tests can uncover hidden imbalances and potential issues before they manifest as noticeable symptoms, offering early intervention and the opportunity to address underlying problems. 

By maintaining optimal ranges and addressing subtle imbalances, you can ensure your body functions at its best, promoting long-term wellness and disease prevention. Regular testing, while it doesn’t feel urgent, serves as a valuable investment for the future of your health and well-being.


In my practice, I emphasize the importance of annual functional medicine lab tests. While there is a wide array of tests to choose from, I have identified a core set of essential labs that I encourage everyone to consider for their annual health assessments. These tests serve as a cornerstone in proactive healthcare, offering invaluable insights into various aspects of well-being and enabling me to tailor personalized recommendations for each of my client’s specific health profile.

labs to check annually
Vitamin D, 25-OH

Vitamin D, specifically in the form of 25-OH vitamin D, plays a pivotal role in our health. It is not just essential for maintaining strong bones and teeth, but it also influences a wide range of aspects concerning our health. For example, adequate vitamin D levels are associated with a stable mood, as it can help regulate neurotransmitters in the brain. Vitamin D is also crucial for a strong immune system, aiding in the body’s defense against infections and illnesses. 

Additionally, vitamin D contributes to balanced hormones, affecting processes like insulin regulation and even influencing fertility in both men and women. Despite its significance, low vitamin D levels are quite common. Fortunately, they can often be improved with simple lifestyle and dietary adjustments, such as spending time in the sun, consuming vitamin D-rich foods, or taking supplements when necessary. Ensuring optimal vitamin D levels is a proactive step towards better physical as well as mental well-being.

Lipid Panel

The Lipid Panel is a comprehensive blood test that scrutinizes various lipoproteins in your bloodstream, encompassing LDL (low-density lipoprotein), HDL (high-density lipoprotein), triglycerides, and total cholesterol. In traditional medicine, the standard response to high cholesterol frequently involves prescribing statin medications. Nonetheless, functional medicine adopts a more holistic approach, seeking to uncover the underlying causes of elevated cholesterol levels, which might include factors like infections, chronic inflammation, or unhealthy lifestyle habits. 

By addressing these root causes, functional medicine strives to provide a more comprehensive and sustainable solution to high cholesterol concerns, therefore creating a thriving environment for your cardiovascular health.


Homocysteine, an essential marker in the body, holds a key role in understanding an overall picture of health. When homocysteine levels rise, it can indicate not only inflammation but also potential dysfunctions within the body, ranging from autoimmunity to heart disease and even hidden infections. Through functional medicine lab tests, I have witnessed countless times how monitoring and addressing homocysteine levels can be a vital part of proactive healthcare.

C-Reactive Protein

C-reactive protein, or CRP, is another valuable marker that provides insights into the body’s inflammatory status. Its significance extends beyond a simple indicator of inflammation, as elevated CRP levels can signal the presence of a range of inflammatory conditions. These conditions might encompass not only general inflammation but also underlying infections, making CRP a crucial component of functional medicine lab tests. 

By monitoring CRP levels, healthcare providers can delve into the intricacies of inflammation, identify potential sources of infection or chronic inflammation, and take targeted steps towards managing these conditions effectively. 

Hemoglobin A1c

Hemoglobin A1c, often referred to as HbA1c, serves as a crucial indicator of the body’s ability to regulate blood sugar levels over an extended period, typically around three months. When HbA1c levels fall outside the normal range, it can be an early indication of potential issues with blood sugar regulation. 

Elevated HbA1c levels are typically associated with two significant conditions: diabetes and pre-diabetes. Diabetes, a chronic metabolic disorder, is characterized by consistently high blood sugar levels, while pre-diabetes represents an intermediate stage with elevated but not yet diabetic blood sugar levels. Monitoring HbA1c levels through functional medicine lab tests enables early detection, facilitating timely interventions such as lifestyle changes, dietary adjustments, and targeted treatments to effectively manage blood sugar levels.


Ferritin, a vital iron-containing protein, serves as a key marker for evaluating iron storage within the body. Understanding ferritin levels is essential for several critical health considerations. First, it provides insight into your body’s iron status, indicating whether there is a sufficient iron reserve for essential bodily functions. 

Second, ferritin levels play a pivotal role in identifying iron deficiency, a condition that can lead to symptoms like fatigue, weakness, and anemia. Beyond this, ferritin also acts as a valuable indicator for assessing oxidative stress since excessive iron levels can contribute to cellular damage. Irregular ferritin levels can be suggestive of various underlying dysfunctions. By maintaining ferritin levels within a healthy range, functional health practitioners can proactively address iron-related issues, reducing the risk of potential health complications associated with iron imbalances.


Insulin is a hormone essential for blood sugar regulation, and is essential in maintaining metabolic health. Its primary function is to facilitate the uptake of glucose from the bloodstream into the body’s cells for energy or storage. However, when the body produces an excess of insulin, it can lead to a condition known as insulin resistance. In this scenario, cells become less responsive to insulin’s effects, necessitating elevated insulin levels to manage blood sugar. Such a situation can pave the way for the onset of diabetes, pre-diabetes, or metabolic syndrome—conditions marked by compromised glucose metabolism and heightened cardiovascular risks. 

Regularly assessing insulin levels through functional medicine lab tests is crucial for the early detection of insulin resistance, enabling timely interventions like lifestyle modifications and dietary adjustments.

Comprehensive Metabolic Panel (CMP)

A Comprehensive Metabolic Panel (CMP) is a comprehensive assessment that encompasses a range of essential markers, including glucose, calcium, total protein, bilirubin, BUN, creatinine, albumin, and electrolytes such as sodium, potassium, and magnesium. This multifaceted test serves as a valuable tool for evaluating the overall health of vital organs like the liver and kidneys. Additionally, it provides critical insights into the balance of electrolytes, which are essential for various bodily functions, including nerve signaling, muscle contractions, and maintaining proper hydration levels.

Renal Function Panel

A Renal Function Panel is a crucial diagnostic tool for evaluating the health of your kidneys, and its significance becomes even more apparent if there is a family history of kidney disease. This comprehensive assessment provides valuable insights into how well your kidneys are functioning and can serve as an early warning system for potential kidney-related issues. 

By monitoring kidney function through functional medicine lab tests, you not only gain a proactive advantage in preventing kidney disease but also gain a deeper understanding of your genetic predisposition to such conditions.

FULL Thyroid

A comprehensive Full Thyroid Panel is an indispensable diagnostic tool that goes beyond a basic thyroid assessment. It meticulously evaluates multiple essential markers, including T3, T4, Free T3, Free T4, TSH, Anti-TPO, Reverse T3, and Anti-TG. This thorough examination of thyroid function is critical for gaining a comprehensive understanding of your thyroid health and can help in the early detection of thyroid dysfunction or autoimmune thyroid conditions. Unlike a basic thyroid panel, which may overlook crucial details, a full thyroid panel leaves no stone unturned, ensuring a precise evaluation of thyroid function and autoimmune markers. 


Hormone testing is a cornerstone of functional medicine. A comprehensive hormone panel typically includes specific markers like estradiol, which is crucial for female reproductive health and bone density; DHEA, which is an important precursor hormone for vitality and stress response; SHBG, which is a carrier protein that affects hormone availability; Cortisol which is the pivotal stress hormone influencing metabolism. 

Also included in the panel should be total testosterone and free testosterone, vital for sexual function and muscle mass. Finally, progesterone, which is essential for a healthy menstrual cycle and pregnancy support. Meticulously examining these specific hormonal markers helps identify deficiencies, excesses, or irregularities, allowing for tailored interventions.

CBC w/ Differential + Platelets

A Complete Blood Count (CBC) with differential and platelets is a comprehensive blood test that offers a thorough analysis of various aspects of your blood composition. This test assesses key components such as red blood cells, white blood cells, platelets, hemoglobin, and hematocrit levels, providing a comprehensive overview of your blood health. 

This test is a valuable tool in functional medicine, helping to pinpoint a wide range of health conditions, including underlying infections, autoimmune disorders, inflammatory issues, hematological disorders, and even specific types of cancer. 

RBC Magnesium

RBC Magnesium testing becomes particularly important in functional medicine assessments because it offers a precise measure of magnesium levels within red blood cells. This specific test is like a magnifying glass for nutrient deficiencies, helping us identify issues like inadequate magnesium intake, malabsorption problems, or even early signs of kidney disease. 

By examining the concentration of magnesium in red blood cells, we get a detailed snapshot of your overall magnesium status. With this information, we can tailor interventions through dietary tweaks, supplements, or specialized treatments to fine-tune your magnesium levels. 

Sedimentation Rate

Sedimentation Rate, often referred to as the erythrocyte sedimentation rate (ESR), is a widely used diagnostic marker in the realm of functional medicine. This test serves as an incredible tool for assessing inflammation within the body. It operates on a straightforward principle: when inflammation is present, certain proteins within the blood tend to clump together, causing red blood cells to fall more quickly to the bottom of a test tube. The rate at which this sedimentation occurs is measured in millimeters per hour (mm/h), with a higher rate indicating more significant inflammation. 

Elevated sedimentation rates are frequently observed in individuals with various health conditions, including autoimmune diseases, certain cancers, and various inflammatory disorders. 

Antinuclear Antibody (ANA)

The Antinuclear Antibody (ANA) test plays a pivotal role in functional medicine diagnostics. It delves into the complexities of the immune system by searching for antinuclear antibodies in the bloodstream, offering a window into immune system functioning, particularly concerning autoimmune conditions. Autoimmunity occurs when the immune system mistakenly targets the body’s own tissues, leading to persistent inflammation and a range of symptoms.

The ANA test stands out for its sensitivity, allowing it to detect even subtle signs of autoimmune disorders, which is crucial for early intervention and personalized treatment plans. By identifying the presence of antinuclear antibodies, practitioners gain valuable insights into immune system dysfunction, which then allows us to address autoimmune diseases promptly and get a jumpstart on enabling you to live your fullest, healthiest life.


In addition to the primary lab tests above, there are specific functional medicine tests that are helpful to run annually. In many cases, you’ll need to work with a functional medicine practitioner to access these tests:

functional medicine lab tests for leaky gut & autoimmunity
GI Map

The GI Map (Gastrointestinal Microbial Assay Plus) is an advanced diagnostic tool in functional medicine, providing a comprehensive assessment of the gut’s very intricate ecosystem. This specialized test offers insights beyond conventional stool testing by analyzing the gut microbiome’s composition and diversity. It can identify imbalances in the microbiome, such as dysbiosis. This is where beneficial and harmful bacteria are out of balance – a condition that is linked to various health issues. 

Additionally, the GI Map is highly sensitive in detecting infections, including harmful bacteria, viruses, fungi, and parasites that can disrupt gut health and lead to chronic digestive problems. By unraveling the complexities of the gut, the GI Map empowers functional health providers to tailor precise treatment strategies to ultimately promote better digestive health.

You can learn more about the GI Map here. 

Micronutrient Analysis

A Micronutrient Analysis, as the name suggests, delves deep into our body’s nutritional intricacies. This test offers a comprehensive evaluation of essential micronutrients, including vitamins, minerals, antioxidants, and more, which are the building blocks of our health. By scrutinizing these micronutrient levels, this test can shed light on potential deficiencies, providing valuable insights into our nutritional well-being. 

These deficiencies, if left unaddressed, can contribute to a range of common health issues like fatigue, cognitive fog, immune system vulnerabilities, skin concerns, and even chronic diseases. The good news is that by identifying these deficiencies, we can take proactive steps to rebalance our nutritional status, whether through targeted supplementation or dietary adjustments, therefore resulting in a much happier and healthier life.

You can learn more about the micronutrient test I prefer here.


The LEAP MRT (Mediator Release Test) is a remarkable tool in functional medicine, harnessing mediated-release technology to pinpoint food sensitivities that often go undetected. Unlike food allergies, these sensitivities may not trigger immediate reactions but can significantly impact our health. Recognizing these sensitivities is vital, especially when it comes to healing the gut and addressing autoimmune conditions. 

By identifying specific trigger foods that may be silently contributing to inflammation and immune responses, the LEAP MRT enables functional health providers to create tailored plans that actively reduce inflammation and support the gradual restoration of gut health. This personalized approach is a key strategy to reverse autoimmune disorders and enhance overall vitality, putting you back in control of your health journey.

You can learn more about the Leap MRT test I reccommend here.

Wheat Zoomer

The Wheat Zoomer is a diagnostic tool that zeroes in on antibodies linked to gluten sensitivity, going beyond a mere confirmation of intolerance. It delves into the intricacies of gluten-related reactions, giving detailed insights. This process isn’t just about recognizing gluten sensitivity; it’s an important step in addressing and healing gut conditions, including the notorious leaky gut. 

By identifying these gluten-related antibodies, we gain a deeper understanding of what might be triggering gut inflammation and permeability issues. Armed with this knowledge, providers can tailor strategies for intentionally healing the gut, whether that means adopting a gluten-free diet, exploring specialized gut-healing protocols, or making specific lifestyle adjustments. The Wheat Zoomer’s insights enables providers to take precise actions that support your journey feeling your absolute best.

In addition, testing intestinal permeability is extremely important so we not only have a baseline and understanding of where our gut is when starting a plan to  heal, but also so that progress can be measured. I will always use this panel to confirm a custom protocol is working for the person and that the needle is going in the right direction. This information is invaluable to helping my clients heal (after a long road of spinning their wheels). 

You can read more about how a Wheat Zoomer can help you identify gluten sensitivity and intestinal permeability here. 

functional medicine lab test differences

It is important to note that most conventional practitioners will not automatically test the basic lab panels I recommend annually. I highly recommend taking a list of functional medicine lab tests with you when you consult with your doctor or functional practitioner. Being specific about the tests you’re interested in is key to getting the most comprehensive assessment of your health. Don’t forget to inquire about insurance coverage and self-pay options, as conventional medicine doctors may sometimes hesitate to order these specialized labs. If you encounter resistance, I strongly suggest seeking out a functional medicine practitioner who is well-versed in the importance of these tests and can guide you through the process.


Functional medicine lab tests are truly a game-changer when it comes to holistic health. They can provide invaluable insights into your unique chemistry, allowing providers like myself to address deficiencies, gut infections, food intolerances, intestinal permeability, genetics, hormones, and toxins in a personalized and precise manner. 

If you aren’t sure where to go next with testing labs or you don’t have a practitioner to hold your hand through the process, I would love to support you! Inside my Microbiome Makeover program, I use lab testing as the foundation. It’s a comprehensive 12-week hybrid coaching program that dives deep into your lab results and offers a custom blueprint and personalized protocol to optimize your health. It’s specifically designed to jumpstart your journey in helping you to heal your gut and reverse autoimmunity. 

Throughout the program, you’ll have access to personalized lab interpretations, in-depth training videos, bonus breakthrough coaching sessions, and custom protocols to ensure you’re on the right track. You’ll leave the program feeling empowered with detailed write-ups, action plans, and resources for success, including guides, recipe booklets, meal plans, and a private client-only portal. This portal allows you to access your materials from anywhere, including HIPAA-protected secure networks for added privacy. You’ll even have access to my online supplement dispensary that will give you access to the best supplements to support your healing. If this is speaking to you and you know you need to go deeper, here’s how you can apply and get on the waitlist

Let’s partner together on this journey to take control of your health! Investing in your health is an investment in personal freedom from the inside out. Comment below if you are going to commit to testing your labs annually and be your own health advocate!

  1. Cora Diaz says:

    Hi Nikki,
    This is truly wonderful information, thank you. I hope by adding my e-mail below will put me on a newsletter or blog list.
    Enjoy your day,

    • Nikki Yelton says:

      Hi Cora!! This means the world to me and I am so thankful you shared a comment to let me know it was helpful for you! We can definitely get you on our list. Unfortunately we can’t do it manually due to email regulations but if you go to this page there’s a simple sign up form so you can get onto our VIP list. I am looking so forward to connecting with you! 🙂

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"When it comes to balancing our body, healing the gut, reversing autoimmunity, and achieving optimal health—we are a lot like a car that won’t run right. In order to fix the problem once and for all instead of relying on jumper cables, we must get underneath the hood, run the diagnostics, and replace the battery so that it runs good as new."

-Nikki Yelton, RD

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